Balzano Vittoria, Laurent Emeline, Florence Aline-Marie, Lecuyer Anne-Isabelle, Lefebvre Carole, Heitzmann Patrick, Hammel Pascal, Lecomte Thierry, Grammatico-Guillon Leslie
OncoCentre, Cancer network of the Centre-Val de Loire region, Tours, France.
Gastroenterology and Digestive Oncology Department, Teaching Hospital of Tours, Tours, France.
Ther Adv Med Oncol. 2022 Sep 5;14:17588359221113264. doi: 10.1177/17588359221113264. eCollection 2022.
Excessive waiting time intervals for the diagnosis and treatment of patients with pancreatic cancer can influence their prognosis but they remain unclear. The objective was to describe time intervals from the medical visit to diagnostic imaging and to treatment and their prognostic impact in pancreatic cancer in one French region.
This retrospective observational multicentre study included all patients with pancreatic cancer seen for the first time in 2017 in multidisciplinary team meetings (MTMs), where clinical data were collected. A probabilistic matching with the medico-administrative data from the French national healthcare database () was performed to define the care pathway from clinical presentation to the beginning of treatment. Median key time intervals were estimated for both resected and unresected tumours. Factors associated with 1-year survival were studied using Cox model.
A total of 324 patients (88% of total patients with MTM presentation) were matched and included: male 54%, mean age 72 years ±9.2, Eastern Cooperative Oncology Group (ECOG) PS > 1 19.5%, metastatic disease at diagnosis 47.4%, tumour resection 16%. At 1 year, 57% had died (65% in the unresected group and 17% in the resected group). The median time interval from the medical visit to diagnostic imaging was 15 days [Q1-Q3: 8-44]. After imaging, median time intervals to definite diagnosis and to first treatment were 11 and 20 days, respectively. Significant prognostic factors associated with the risk of death at 1 year were ECOG PS > 1 (hazard ratio (HR) 2.1 [1.4-3.0]), metastasis (HR 2.7 [1.9-3.9]), no tumour resection (HR 2.7 [1.3-5.6]) and time interval between the medical visit and diagnostic imaging ⩾25 days (HR 1.7 [1.2-2.3]).
Delay in access to diagnostic imaging impacted survival in patients with pancreatic cancer, regardless of whether tumour resection had been performed.
胰腺癌患者诊断和治疗的等待时间过长会影响其预后，但目前尚不清楚具体情况。目的是描述法国一个地区胰腺癌患者从就诊到诊断性影像学检查及治疗的时间间隔及其预后影响。
这项回顾性观察性多中心研究纳入了2017年在多学科团队会议（MTM）中首次就诊的所有胰腺癌患者，并收集了临床数据。通过与法国国家医疗数据库的医疗管理数据进行概率匹配，以确定从临床表现到治疗开始的治疗路径。估计了切除和未切除肿瘤的关键时间间隔中位数。使用Cox模型研究与1年生存率相关的因素。
共匹配并纳入324例患者（占MTM就诊患者总数的88%）：男性占54%，平均年龄72岁±9.2岁，东部肿瘤协作组（ECOG）体能状态评分（PS）>1分的占19.5%，诊断时出现转移的占47.4%，肿瘤切除率为16%。1年时，57%的患者死亡（未切除组为65%，切除组为17%）。从就诊到诊断性影像学检查的时间间隔中位数为15天[四分位间距（Q1-Q3）：8-44天]。影像学检查后，明确诊断和首次治疗的时间间隔中位数分别为11天和20天。与1年死亡风险相关的显著预后因素包括ECOG PS>1分（风险比（HR）2.1[1.4-3.0]）、转移（HR 2.7[1.9-3.9]）、未进行肿瘤切除（HR 2.7[1.3-5.6]）以及就诊与诊断性影像学检查之间的时间间隔≥25天（HR 1.7[1.2-2.3]）。
无论是否进行肿瘤切除，获得诊断性影像学检查的延迟都会影响胰腺癌患者的生存。
